Just one. There is no requirement to monitor more than one physiologic parameter.

A new clinic can be live with us in as fast as 24 hours, although with training and EHR integration, the typical onboarding period is 3 to 5 business days.

Book an appointment with one of our client specialists using this link. Our client specialist will make sure that you understand the program and get your onboarding information loaded into our system so that you can get started quickly.

A new clinic can be live with us in as fast as 24 hours, although with training and EHR integration, the typical onboarding period is 3 to 5 business days.

Book an appointment with one of our client specialists using this link: Schedule a Demo Link

All patient monitoring and care coordination is performed by Qualified Healthcare Professionals who are licensed and based in the United States. Health Nexus provides a nationwide English- and Spanish-speaking clinical team of nurses and medical assistants who deliver first-line monitoring of patient vital sign data 24/7/365.

When a patient’s biometric data exceeds a critical threshold, Health Nexus’s clinical team contacts the patient through its platform on a recorded line and performs a clinical assessment. The nurse or clinical team member then determines whether the case should be escalated to the ordering physician and, when appropriate, contacts the physician directly.

This clinical screening model helps reduce alert fatigue and operational “noise” for providers by filtering abnormal readings before they reach the physician. As a result, ordering physicians can deploy RPM programs with less administrative burden, less overnight disruption, and greater confidence that clinically meaningful alerts are being reviewed and escalated appropriately.

Many RPM vendors do not provide clinical monitoring services, which can leave the provider’s office responsible for reviewing and responding to every abnormal vital sign reading — including those that occur overnight, on weekends, or during holidays. Health Nexus’s model is differentiated because it includes ongoing clinical monitoring and escalation support as part of the RPM service.

Health Nexus gives physicians the flexibility to set customized clinical thresholds for each vital sign being monitored, including blood pressure, heart rate, glucose, weight, oxygen saturation, and other biometric data points. Providers can establish default thresholds at the practice or program level, while also tailoring thresholds for individual patients based on their unique clinical profile.

This level of customization is important because patient risk levels, baseline readings, diagnoses, and care plans can vary significantly. A threshold that is appropriate for one patient may create unnecessary alerts for another, or may not be sensitive enough for a higher-risk patient.

By allowing both program-level and patient-specific thresholds, Health Nexus helps physicians reduce false alarms, improve clinical relevance, and better align RPM alerts with each patient’s actual care needs.

Not all RPM vendors offer this degree of threshold customization, which can limit clinical flexibility and increase unnecessary alert volume for providers.

RPM devices do not need to be specifically “FDA-approved,” but they must meet the FDA’s definition of a medical device and be appropriate for capturing medically relevant physiologic data. This distinction is important because RPM reimbursement generally depends on the use of connected medical devices that support clinical monitoring, rather than ordinary consumer-grade wellness tools.

No. RPM cannot be done with self-reported data.

We provide the first RPM device for each patient as part of our service, and most patients only require one device to participate in the program.

This helps reduce upfront cost and operational friction for providers. Instead of requiring the practice to purchase a large inventory of devices before launching, our model allows physicians to begin offering RPM without a major capital investment.

Many vendors require clinics to buy devices in bulk or commit to significant upfront hardware purchases. That can create financial risk, unused inventory, and a slower path to implementation. By including the initial device as part of the service, we make RPM easier to adopt, easier to scale, and less burdensome for the practice.

RPM can be reimbursed across multiple payer channels, including Medicare, Medicare Advantage, Texas Medicaid, and select private insurers. Medicare reimbursement is structured as a Part B service, while Texas Medicaid covers similar services under its “telemonitoring” framework using separate coding rules. This creates multiple potential reimbursement pathways, though payer-specific coverage and billing requirements should be verified before enrollment.

99453, 99454, 99457, 99458

CPT 99453 — RPM Setup and Patient Education

CPT 99453 is a one-time billable code associated with initiating the RPM program for a patient. This typically includes explaining the program, obtaining the patient’s acceptance to participate, and providing introductory materials, such as an Health Nexus brochure. For billing purposes, the Date of Service is typically the date of the patient’s first successfully recorded reading transmitted into the Health Nexus platform. This code generally reimburses approximately $15 to $20, depending on the locality and payer fee schedule.

CPT 99454 — RPM Device Supply and Data Transmission

CPT 99454 covers the ongoing provision of RPM device(s), the software used to receive and ingest patient readings, and the continued functionality of the device and technology platform. This code is billed once every 30 days. To qualify for billing, the patient must record at least one successful reading during the applicable 30-day period. For Health Nexus, the first Date of Service for CPT 99454 is the date of the patient’s first successfully recorded reading in the Health Nexus platform. After that, the code is billed every subsequent 30 calendar days, assuming the billing requirements are met. CPT 99454 typically reimburses approximately $55 to $62, depending on locality and payer fee schedule.

CPT 99457 — RPM Treatment Management Services

CPT 99457 covers at least 20 minutes of interactive telemonitoring services provided to the patient and/or the patient’s caregiver during a calendar month. This time may include clinical monitoring, patient communication, review of biometric data, care coordination, and related RPM treatment management activities. The required time can be furnished incident to the billing provider and under the clinic’s general supervision, which means Health Nexus may provide 100% of the required service time on behalf of the clinic, where permitted. Clinics are encouraged to work within the Health Nexus platform because any eligible time spent by clinic staff can also count toward the cumulative monthly time requirement. CPT 99457 typically reimburses approximately $49 across most localities, depending on the payer and fee schedule.

CPT 99458 — Additional RPM Treatment Management Time

CPT 99458 covers each additional 20-minute unit of cumulative interactive telemonitoring services provided to the patient and/or the patient’s caregiver during a calendar month, after the initial 20 minutes required for CPT 99457 have been met.

Use the CMS Tool | https://www.cms.gov/apps/physician-fee-schedule/license-agreement.aspx

Not exactly. 99453 is a one-time code. 99454 is an every-30-day code, not to be confused with 99457 and 99458 which are calendar month codes.

RPM can be billed alongside other care management programs, such as CCM, TCM, and BHI, but providers must avoid double-counting time across services. CPT 99454 is billed once every 30 days regardless of the number of devices or vital signs monitored.

RPM may also be delivered as an “incident to” service, allowing qualified care team members to support the program under the supervision of an eligible billing provider.

No. You can not round up time.

Before enrolling a patient in RPM, the ordering provider should confirm and document patient consent. The consent can be verbal, but it should be noted in the medical record. This is important because Original Medicare patients may have 20% cost-sharing responsibility unless covered by secondary insurance.